The following is an edited transcript of the Journal Club with Pearls & Marketing (JCPM) of December 23, 2025 with Charles Runels, MD.  

Topics Covered

• The Prophecy is Between the Lines
• Review of PRP for Interstitial Cystitis
• The Reason I Spent over Two Million Dollars over the Past Twenty-Six Years to Learn Marketing
• Androscan MIT Device Shows P-Shot® Combination Beats Cialis
• Treating Peyronie’s Disease “Update”?
• “To Generate Heat Not Light is the Intention”
• Implementation Kit
• References
• Helpful Links

Charles Runels, MD
Author, researcher, and inventor of the Vampire Facelift®, Orchid Shot® (O-Shot®), Priapus Shot® (P-Shot®), Priapus Toxin®, Vampire Breast Lift®, and Vampire Wing Lift®, & Clitoxin® procedures.

Transcript

Thank you for being at our journal club on Christmas Eve-Eve. I will keep it short and try to make it worth your time.

The Prophecy is Between the Lines

Let’s start with this paper, which I will put in the handout section right now.^[1] One of the main points of this paper is not actually in the paper. Notice that they’re not debating about whether platelet-rich plasma is helpful for an osteoarthritis of the knee. They’re talking about how to optimize clinical outcomes.

This, I think, heralds what will be happening in the GYN and urology space 10 years from now. Remember the orthopedic surgeons were using platelet-rich plasma for 10 years before we started picking it up and using it in the urology and gynecology space. And so 10 years ago when I was first introduced to platelet-rich plasma, when I would read the orthopedic literature, by that time they had quit debating that much about whether it works or not, and they were getting to the nuances about how to make it work better.

Prophecy: That’s where our colleagues are headed—we will quit debating the usefulness of PRP as a tools and think more about the nuances of how to use the tool (we are already to this point within the CMA).

And I think you can get clues, even if you don’t treat joints, you can get clues about what might be coming or what we might find by studying the orthopedic literature. And then of course, the same thing can be said about the cosmetic use of it, which came later, mostly because faces and genitals have lots of blood flow, so we weren’t as motivated. Twenty years ago, as in physicians, were not as motivated to explore the tool because wound healing came easily. And now that we can see ways that might help, then we might get clues about how to improve the results of it by looking to see what the orthopedic surgeons have found.

So having a patient, for example, who has been fasting increases growth hormone. And of course, the things we all know, like not on non-steroidals and not smoking and all the things that would help wound healing would help this, as well.

I’m looking now at going again through the study of the over a thousand cohort of over a thousand women who received our O-Shot® and were followed for a year, and it is true what we know that more than one procedure improves the results, and the literature seems to be demonstrating that probably about eight weeks apart, six to eight weeks apart has been best. But you see there’s talking about one to four weeks apart for pain relief. That’s, to me, an outlier.

Most people are going four to six weeks apart and they all have the same complaint. There’s a very significant heterogeneity among the protocols and everyone’s using a different preparation, and some actually are showing less. This is new. We’ve had several studies we’ve covered now that showing even fewer platelets might work better than more. And where that sweet spot is may vary depending on what we’re treating.

One recent study in hair showed the lower numbers of platelets worked better. And so the things that they talk about affecting are not new, but I pointed out because it’s heralding, as I just said, that we are going to more and more look at how to make things work better instead of just if it works or not.

Yes, it’s a useful tool to help with dysphonia and urinary function and sexual function, and probably it will be similar factors. So that’s the only purpose for this one. It just came out.

You can see it’s sports medicine. And you’ve heard me rant many times that, especially in the muscle arena, what’s good for an NFL athlete’s muscle is good for your mother or your wife or your sister’s pelvic floor muscle.

Review of PRP for Interstitial Cystitis

This one is definitely worth pointing out.^[2] It’s shocking how many people have chronic pain from interstitial cystitis and they’ve just given up on finding help. And this is another study, look at this: 372 retrieved articles, 426 patients. So here’s a systemic review article to look at using PRP for interstitial cystitis or bladder pain syndrome.

And most of these studies have to do with injecting directly into the bladder, but we have, I’ve just lost count of the number of people in our group, have told me about having amazing results just doing our basic O-Shot® procedure. So this is another study you can brag about to your patients and the woman who hasn’t come to see you, yet, for this problem because she’s giving up on finding help, this can be a very great encouragement and it provides the opportunity to do what we went into medicine to do, which is to change lives.

I remember as a ER doctor, it was fun to give antibiotics and help someone’s earache go away. But actually, studies show that depending on the age of the patient and a lot of times what you’re doing with the antibiotic, the earache’s going to go away at about the same rate. Whether you give antibiotics or not, mostly what you’re doing is preventing complications. The last time I read about strep throat, you got a sore throat? It’s going to go away. You’re mostly decreasing the possibility of myocarditis and not really hastening the resolution of the sore throat.

And so it feels like maybe we’re just not changing lives, just going through the motions until you have someone who’s had pain for a decade from their Lichen sclerosus or their interstitial cystitis and you give them an O-Shot® and their life changes dramatically, or they have Peyronie’s disease, or they have erectile dysfunction and you do something, and now their life is different. And you can’t get that on the thing on Amazon where you can have a doctor visit now for 25 bucks by text message. That would’ve put you in jail 10 years ago, but now it’s the deal, but you can’t get an O-Shot® or a P-Shot® by video or text message on Amazon and this changes lives.

The Reason I Spent over Two Million Dollars over the Past Twenty Six Years to Learn Marketing

I built my first website in 1998 and started writing emails as part of a consistent effort to help me find patients in 2003, 23 years ago, and I learned from some of the best ever, some of the legends in marketing and in email marketing.

=> Apply for Online Training for Multiple PRP Procedures <=

The reason I did it was that was the year that I gave up accepting insurance and went to an all cash practice. And we may not say it directly, but part of the reason we have, we accept, as physicians, insurance carriers, and we put up with the abuse, is we think we cannot connect with people who need us without the pimp. They’re pimping us out and we accept what they pay us for fear that we won’t be able to find someone who has the problem and can afford to pay us, or we can’t afford to stay in business if they do not pay us: we think we can’t live without the pimp.

And that is part of the reason why learning a simple, easy way to market is critical for doing what we do because much of it, insurance does not pay for.

I will speak with some, for some reason, I see it a lot in urologists more so than some of the other specialists.

They’ll say, “Well, I like the idea of the P-Shot®. Does insurance pay for it?”

I’ll say, “No.”

And they will suddenly go into this looping trance where they’re just literally like the proverbial deer in the headlights and then they say, “Well, I guess I can’t do it.”

Which is shocking, because oftentimes, they’re accepting cash for penile implants, but I think there’s this idea that if there’s a device or a surgery involved that somehow that makes it okay to accept cash. I don’t know, maybe they’re afraid they can’t talk about it and connect with it. I’m not sure, but I see it a lot.

=> Apply for Online Training for Multiple PRP Procedures <=

But that is why I studied marketing and spent a lot of money in the past 20 plus years studying it, because it enables me to connect with people who need what I know how to do.

And it’s why I keep pushing just simple little emails, but I don’t want to mislead you. When you send out an email, you won’t have 30 people call. You’ll have two or three, and one of them will give you money and make an appointment, and that doesn’t change your life—but it changes that one person’s life.

And, if you send another email a few days or a week, never longer than a week, that teaches your patients something else that you’re able to do and why it works, then you get another patient or two.

 And that practice, not an event, not a one email or one billboard, but that practice of sending out simple little educational messages will give you a steady flow of patients and grow your practice.

So, with that in mind, this is a recent study (which makes it news) and there is someone in your community who needs to know that you know how to make their interstitial cystitis better. I just gave you a link to that and because it’s open source, you can send them that link.^[3]

Androscan MIT Device Shows P-Shot® Combination Beats Cialis

This one, I don’t know what this is. Let me pull it up because I’m going to admit, I’m not sure what this Androscan MIT device is, but let me show you how I’m talking about it.

They divided men into groups, four groups. Group one received negative pressure therapy, low intensity shockwave therapy, and Avantron chair stimulation, 10 sessions.

Group two patients received low dose Cialis, five milligrams.

And group three, they got combined therapy with local negative pressure therapy, shockwave therapy, Avantron chair simulation, and PRP five sessions.

And group four, control group, were healthy volunteers and they did the [inaudible 00:11:32] score.

Androscan MIT measurements before and after treatment. In group three, a significant improvement was observed.

Go back and look at what group three was. Combined local, negative pressure, shockwave, Avantron chair stimulation, and PRP.

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And if you look at group one, negative pressure, shockwave, group two, the daily Cialis.

It was the group that got the PRP that improved (more than the shock wave alone and more than Cialis alone).

Of course, they got other things. They got the low negative pressure therapy and shockwave and Avantron.

There wasn’t a PRP alone group, but the group that got the PRP as part of the treatment, their score increased the most.

And absolute increase in penile diameter increased and number of nocturnal erections the most in the PRP group.

The Androscan MIT device is a system used to measure nocturnal penile tumescence. I’ve seen another device that works similar to this. It’s like a cock ring you wear and it has a feedback to an app in your phone. So there’s more than one device coming out like this. And I don’t know if anyone in the group has experience with it.

I would love for you to teach me about it, and others in the group because I’ve never used it, but I’m going to try to get my hands on it.

I do like the idea of having something objective other than our survey. Ultrasound is nice, but to have something that’s actually measuring nocturnal erections.

The one that I saw, I liked it a lot, but the thing that bothered me about it because it’s a cock ring, it’s not only measuring, but it’s changing.

If you have a device, a constrictor band that has a measurement on it and you don’t even get a P-Shot®, you’re probably going to have more penile nocturnal tumescence because you’re restricting venous outflow.

I’m looking for something that measures without changing. That it measures without changing, and this looks like it. It could have that possibility.

There’s the study. It could be that it could be also another source of income, as well as help us with some of our future research and give us another objective measure. I like to always at least do female sexual distress scale.

And remember, I made a place for you to get female sexual function index done online for free. If you want to make that part of your evaluation, I’ll put a link to that for you in the email that goes out if you’re not sure where to find it.

But some sort of objective measure, I think, is important. And a lot of times people who think they’re not better because they don’t remember three months ago. When you show them the change in their scores, it helps you confirm to the patient you helped them.

Treating Peyronie’s Disease “Update”

I like to show you the things that don’t match up with what I’ve seen. I don’t want our journal club to be an echo chamber. In this article they talk about Peyronie’s disease, and they mention using shockwave, that it works, and they mentioned verapamil (old school, not so good in my observation) and they’re still classifying PRP and mesenchymal cells as experimental.^[4] 

That seems to me behind what we have seen with Dr. Virag’s study,^[5] which was now at least five years ago and others,^{[6] [7] [8] [9] [10]} seems like maybe they’re not ready to embrace it as much as we are, which is why I’m showing it to you.

Still, if you just knock the science debate out of it and just put yourself in the place of the patient, they’re very, what’s the right word? They’re very accepting of surgery in the article, and there’s a place for that, right? Surgical methods, placation, incision graphing, penile prosthesis.

But, who wants to sign up for that as the first choice?

Anyone?

Anyone?

Who would not want to try our P-Shot® procedure first, which has the possible side effect of improved erections before they go to surgery, or even before they go to Xiaflex, which is a series of injections. If you pay for the series, it’s over $20,000 and it has this risk of penile fracture, which will often be followed by a penile implant.

So, I feel that from a scientific standpoint, it makes sense to say definitely what we’re doing hasn’t been around as long as penile implants, but from a patient standpoint, who would not want to try what we do first? Verapamil to me is so old school, it’s way down on my list. If you look at the numbers on it just doesn’t work that well.

If you want to see our whole protocol, go to priapusshot.com/peyronies

And we have the only standardized protocol that has been around for over a DECADE!^[11]

I reviewed the literature and found everything that I could find with significant research to help with Peyronie’s. And yes, there are studies that show if you take that many units of vitamin E, that much CoQ10, it can help with Peyronie’s disease.

The C, I just added in because I think if you’re building collagen, you need it. I’m a big fan of Linus Pauling. He lived to be almost 100 and he took three grams of vitamin C three times a day. He took nine grams of vitamin C a day.

I also give you some protocols there, P-Shot®, wait six weeks, another P-Shot®. And then if no improvement, okay, maybe you do your Xiaflex. And then after that, maybe it’s another P-Shot® to help, because remember, Peyronie’s is thought to have an autoimmune component and PRP down regulates the autoimmune response, which is part of the reason why if you do surgery and take out the scar tissue, shrink the penis, but you also have a risk of it recurring at another place in the penis down the road.

These are just things that you would do, I think, normally just to help with erectile dysfunction and walking helps decrease inflammation, improves erection quality. And of course, smoking is a risk factor for it.

And Cialis, not just by improving blood flow, but Cialis is a standalone. Daily low dose Cialis is thought to be helpful and down regulating the etiology and the research for that is right there.

So that’s the whole protocol and I think it helps to give that just to your patients and then just say, “Let’s do all these things.”

Anyway, I’m telling you that, but at the same time, I want you to see that some are still not embracing it as something that you do right off the bat.

In my opinion, scientifically, they might be right, but if it’s your penis, I would not undergo and penile implant before trying a P-Shot® procedure.

I think with that, I just want to show you one book and then let’s end it. I’ve been working my way through. It’s an old one, but it makes a point about marketing that is worth saying, and then we will call it a night and we will be right at 30 minutes. Just a second.

“To Generate Heat Not Light is the Intention”

This book came out in the 50s and I just want you to see one paragraph in the introduction because it makes the point of the book, but it also makes the point of all of our marketing efforts.^[12]

Here’s the quote:

“Ours is the first age in which many thousands of the best trained individual minds have made it a full-time business to get inside the collective public mind. To get inside in order to manipulate, exploit, control is the object now. And to generate heat not light is the intention [passion, not reason]. To keep everybody in the helpless state engendered by prolonged mental rutting is the effect of many ads and much entertainment alike.”

And then he proceeds to demonstrate his point for you in 1950s ads and newspapers.

The idea is the “folklore” of the industrial man. 

The point I want to make is that there is a folklore that is absolutely created by those who sell pharmaceuticals for a living.

I’m not anti-drug. If I’m septic, I want strong antibiotics. If I have surgery, I want anesthesia. I want drugs.

But there is definitely a very, very strong, very, very strong mechanical folklore that is being pushed upon us and created by the brightest of minds, with many, many billions of dollars spent to do what the quoted paragraph says.

And we, us, those of us who are using what the body makes, the regenerative material that our own bodies make are battling against this force to communicate that in some cases there is a better way.

Those with great minds, with lots of money behind them, who are in the business to generate heat, not reason. And (for example) they are teaching that you need Xiaflex, even though it’s been pulled from every European country and Canada and Japan, you need Xiaflex, not a P-Shot® if you suffer with Peyronie’s disease. You even need verapamil, not a P-Shot® for your Peyronie’s disease.

And so when I get up in the morning, I love my family and I love the holiday season and I love what’s happening now, and I want to let you back to your family, but I want you to go bed proud that we are trying to shed light (not heat) and the science is backing up what we’re doing.

It’s a true David and Goliath battle for the mind of patients who might be helped by what we know how to do and we are definitely not Goliath.

And that’s what we’re doing when we meet, it’s what we’re doing when we talk with our patients and we send out simple emails and Twitters or whatever you do, whatever your favorite flavor of communicating and teaching your patients, this is what you’re up against.

And that gives me pride that I think we are actually winning!

And I think with that, we’ll call it a night, and I hope that you have a wonderful week with your family.

Goodnight.

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Implementation Kit

Here’s the Implementation Kit for this week that uses the new research as the basis for patient communications.

Go here do download for free as a member of the CMA (for members only)<–

1. Copy and paste the messages into a new Word document.
2. Then edit it so that it sounds like you.
3. Add a story or a personal observation if you have time.
4. Then, fill in the information with your phone number, etc., and send it to your patients and use your favorite software to send the email.

References

Broul, Marek, Aneta Hujová, and Libor Zámečník. “Modern Possibilities of Diagnosis and Treatment of Peyronie’s Disease in the Czech Context.” Casopis Lekaru Ceskych 164, no. 6 (2025): 262–68.

Culha, Mehmet Gokhan, Erkan Erkan, Tugce Cay, and Uğur Yücetaş. “The Effect of Platelet-Rich Plasma on Peyronie’s Disease in Rat Model.” Urologia Internationalis 102, no. 2 (2019): 218–23. https://doi.org/10.1159/000492755.

Dachille, Giuseppe, Andrea Panunzio, Leonardo Bizzotto, et al. “Platelet-Rich Plasma Intra-Plaque Injections Rapidly Reduce Penile Curvature and Improve Sexual Function in Peyronie’s Disease Patients: Results from a Prospective Large-Cohort Study.” World Journal of Urology 43, no. 1 (2025): 306. https://doi.org/10.1007/s00345-025-05691-5.

Dhillon, Jaydeep, Dylan Parry, and Matthew Kraeutler. “Current Perspectives on Platelet-Rich Plasma Injections for Knee Osteoarthritis: How to Optimize Clinical Outcomes.” Open Access Journal of Sports Medicine Volume 16 (December 2025): 179–86. https://doi.org/10.2147/OAJSM.S567695.

“Errors in Text.” JAMA Network Open 5, no. 11 (2022): e2245075. https://doi.org/10.1001/jamanetworkopen.2022.45075.

Geelhoed, Jeannette P., Olivier Wegelin, Ellen Tromp, Bert‐Jan De Boer, Igle‐Jan De Jong, and Jack J. H. Beck. “Improvement in the Ability to Have Sex in Patients with Peyronie’s Disease Treated with Collagenase  Clostridium histolyticum .” BJUI Compass 4, no. 1 (2023): 66–73. https://doi.org/10.1002/bco2.185.

Hajebrahimi, Sakineh, Fateme Tahmasbi, Elham Jahantabi, Gholamreza Hosseinpour, Rajesh LotfiTaneja, and Hanieh Salehi-Pourmehr. “Platelet-Rich Plasma in Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis.” Advanced Pharmaceutical Bulletin, September 3, 2025, 1. https://doi.org/10.34172/apb.025.45444.

Levine, Laurence A. “Peyronie’s Disease: Contemporary Review of Non-Surgical Treatment.” Translational Andrology and Urology 2, no. 1 (2013): 39–44. https://doi.org/10.3978/j.issn.2223-4683.2013.01.01.

McLuhan, Marshall. The Mechanical Bride: Folklore of Industrial Man. Gingko Press, 2001.

Minore, Antonio, Loris Cacciatore, Fabrizio Presicce, et al. “Intralesional and Topical Treatments for Peyronie’s Disease: A Narrative Review of Current Knowledge.” Asian Journal of Andrology, ahead of print, August 23, 2024. https://doi.org/10.4103/aja202460.

Virag, Ronald, Hélène Sussman, Sandrine Lambion, and Valérie de Fourmestraux. “Evaluation of the Benefit of Using a Combination of Autologous Platelet Rich-Plasma and Hyaluronic Acid for the Treatment of Peyronie’s Disease.” Sexual Health Issues 1, no. 1 (2017). https://doi.org/10.15761/SHI.1000102.

Tags

platelet-rich plasma, PRP therapy, regenerative medicine, O-Shot®, P-Shot®, Priapus Shot®, sexual dysfunction, erectile dysfunction, female sexual dysfunction, Peyronie’s disease, interstitial cystitis, bladder pain syndrome, orthopedic PRP literature, protocol optimization, platelet concentration, PRP activation, treatment intervals, pelvic floor health, gynecology and urology, sports medicine insights, nocturnal penile tumescence, Androscan MIT, shockwave therapy, negative pressure therapy, Avantron chair stimulation, vasculogenic erectile dysfunction, objective outcome measures, patient-reported outcomes, Female Sexual Distress Scale, Female Sexual Function Index, chronic pelvic pain, lichen sclerosus, autoimmune inflammation, PRP versus surgery, non-surgical interventions, marketing for physicians, cash-based medical practice, patient education, evidence-based practice, translational medicine, regenerative protocols, clinical outcomes optimization

Helpful Links

=> Next Hands-On Workshops with Live Models <=

=> Dr. Runels Online Botulinum Blastoff Course <=

=> The Cellular Medicine Association (who we are) <=

=> Apply for Online Training for Multiple PRP Procedures <=

=> FSFI Online Administrator and Calculator <=

=> 5-Notes Expert System for Doctors <=

=> Help with Logging into Membership Websites <=

=> The software I use to send emails: ONTRAPORT (free trial) <=